Skip to main content
SpringerLink
Log in

Arrhythmias in Pregnancy and Postpartum

  • Chapter
  • First Online:
Management of Cardiac Arrhythmias

Part of the book series: Contemporary Cardiology ((CONCARD))

  • 1679 Accesses

Abstract

The significant physiologic adaptations of pregnancy predispose to arrhythmias, while concurrent changes in pharmacokinetics and concerns for fetal health and well-being complicate management. An increased incidence of both atrial and ventricular arrhythmias has been reported in population-based Holter studies, yet most incident pregnancy-related arrhythmias are benign and do not require intervention. Pharmacologic absorption, distribution, metabolism, and elimination are altered, as are gut absorption, protein binding, and hepatic and renal blood flow. This chapter will review antiarrhythmic drug therapy by Vaughn Williams classification, nonpharmacologic arrhythmia therapy (cardiovascular implanted electronic devices and ablation), as well as management of specific cardiovascular conditions during pregnancy, labor, and postpartum.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Gordon MC (2007) Chapter 3 – maternal physiology. In: Obstetrics: normal and problem pregnancies, 5th edn. Churchill Livingstone, an imprint of Elsevier, Philadelphia

    Google Scholar 

  2. Theunissen IM, Parer JT (1994) Fluid and electrolytes in pregnancy. Clin Obstet Gynecol 37(1):3–15

    Article  PubMed  CAS  Google Scholar 

  3. Lindheimer MD, Davison JM (1995) Osmoregulation, the secretion of arginine vasopressin and its metabolism during pregnancy. Eur J Endocrinol 132(2):133–143

    Article  PubMed  CAS  Google Scholar 

  4. Miyamoto S, Shimokawa H, Sumioki H, Touno A, Nakano H (1988) Circadian rhythm of plasma atrial natriuretic peptide, aldosterone, and blood pressure during the third trimester in normal and preeclamptic pregnancies. Am J Obstet Gynecol 158(2):393–399

    PubMed  CAS  Google Scholar 

  5. Duvekot JJ, Peeters LL (1994) Maternal cardiovascular hemodynamic adaptation to pregnancy. Obstet Gynecol Surv 49(12 Suppl):S1–S14

    Article  PubMed  CAS  Google Scholar 

  6. van Oppen AC, Stigter RH, Bruinse HW (1996) Cardiac output in normal pregnancy: a critical review. Obstet Gynecol 87(2):310–318

    Article  PubMed  Google Scholar 

  7. Hunter S, Robson SC (1992) Adaptation of the maternal heart in pregnancy. Br Heart J 68(6):540–543

    Article  PubMed  CAS  Google Scholar 

  8. Clark SL, Cotton DB, Pivarnik JM et al (1991) Position change and central hemodynamic profile during normal third-trimester pregnancy and post partum. Am J Obstet Gynecol 164(3):883–887

    PubMed  CAS  Google Scholar 

  9. Clapp JF 3rd, Seaward BL, Sleamaker RH, Hiser J (1988) Maternal physiologic adaptations to early human pregnancy. Am J Obstet Gynecol 159(6):1456–1460

    PubMed  Google Scholar 

  10. Granger JP (2002) Maternal and fetal adaptations during pregnancy: lessons in regulatory and integrative physiology. Am J Physiol Regul Integr Comp Physiol 283(6):R1289–R1292

    PubMed  CAS  Google Scholar 

  11. Kametas NA, McAuliffe F, Hancock J, Chambers J, Nicolaides KH (2001) Maternal left ventricular mass and diastolic function during pregnancy. Ultrasound Obstet Gynecol 18(5):460–466

    Article  PubMed  CAS  Google Scholar 

  12. Zentner D, du Plessis M, Brennecke S, Wong J, Grigg L, Harrap SB (2009) Deterioration in cardiac systolic and diastolic function late in normal human pregnancy. Clin Sci (Lond) 116(7):599–606

    Article  Google Scholar 

  13. Shotan A, Ostrzega E, Mehra A, Johnson JV, Elkayam U (1997) Incidence of arrhythmias in normal pregnancy and relation to palpitations, dizziness, and syncope. Am J Cardiol 79(8):1061–1064

    Article  PubMed  CAS  Google Scholar 

  14. Li JM, Nguyen C, Joglar JA, Hamdan MH, Page RL (2008) Frequency and outcome of arrhythmias complicating admission during pregnancy: experience from a high-volume and ethnically-diverse obstetric service. Clin Cardiol 31(11):538–541

    Article  PubMed  Google Scholar 

  15. Joglar JA, Page RL (1999) Treatment of cardiac arrhythmias during pregnancy: safety considerations. Drug Saf 20(1):85–94

    Article  PubMed  CAS  Google Scholar 

  16. Walbrandt-Pigarelli DL, Kraus CK, Potter BE (2008) Chapter 81. Pregnancy and lactation: therapeutic considerations. In: Pharmacotherapy: a pathophysiologic approach, 7th edn. McGraw-Hill

    Google Scholar 

  17. Hebert MF, Easterling TR, Kirby B et al (2008) Effects of pregnancy on CYP3A and P-glycoprotein activities as measured by disposition of midazolam and digoxin: a University of Washington specialized center of research study. Clin Pharmacol Ther 84(2):248–253

    Article  PubMed  CAS  Google Scholar 

  18. Hebert MF, Carr DB, Anderson GD et al (2005) Pharmacokinetics and pharmacodynamics of atenolol during pregnancy and postpartum. J Clin Pharmacol 45(1):25–33

    Article  PubMed  CAS  Google Scholar 

  19. Elkayam U, Goodwin TM (1995) Adenosine therapy for supraventricular tachycardia during pregnancy. Am J Cardiol 75(7):521–523

    Article  PubMed  CAS  Google Scholar 

  20. Hagley MT, Cole PL (1994) Adenosine use in pregnant women with supraventricular tachycardia. Ann Pharmacother 28(11):1241–1242

    PubMed  CAS  Google Scholar 

  21. Joglar JA, Page RL (2001) Antiarrhythmic drugs in pregnancy. Curr Opin Cardiol 16(1):40–45

    Article  PubMed  CAS  Google Scholar 

  22. Page RL (1995) Treatment of arrhythmias during pregnancy. Am Heart J 130(4):871–876

    Article  PubMed  CAS  Google Scholar 

  23. Warnes CA (2007) Chapter 77 – pregnancy and heart disease. In: Braunwald’s heart disease: a textbook of cardiovascular medicine, 8th edn. Philadelphia

    Google Scholar 

  24. Rogers MC, Willerson JT, Goldblatt A, Smith TW (1972) Serum digoxin concentrations in the human fetus, neonate and infant. N Engl J Med 287(20):1010–1013

    Article  PubMed  CAS  Google Scholar 

  25. Anderson GD (2005) Pregnancy-induced changes in pharmacokinetics: a mechanistic-based approach. Clin Pharmacokinet 44(10):989–1008

    Article  PubMed  CAS  Google Scholar 

  26. Lees KR, Rubin PC (1987) Treatment of cardiovascular diseases. Br Med J (Clin Res Ed) 294(6568):358–360

    Article  CAS  Google Scholar 

  27. Chan V, Tse TF, Wong V (1978) Transfer of digoxin across the placenta and into breast milk. Br J Obstet Gynaecol 85(8):605–609

    Article  PubMed  CAS  Google Scholar 

  28. Wong RD, Murthy AR, Mathisen GE, Glover N, Thornton PJ (1992) Treatment of severe falciparum malaria during pregnancy with quinidine and exchange transfusion. Am J Med 92(5):561–562

    Article  PubMed  CAS  Google Scholar 

  29. Hill LM, Malkasian GD Jr (1979) The use of quinidine sulfate throughout pregnancy. Obstet Gynecol 54(3): 366–368

    PubMed  CAS  Google Scholar 

  30. Meyer J, Lackner J, Schochet S (1930) Paroxysmal tachycardia in pregnancy. JAMA 94:1901–1904

    Article  Google Scholar 

  31. Allen NM, Page RL (1993) Procainamide administration during pregnancy. Clin Pharm 12(1):58–60

    PubMed  CAS  Google Scholar 

  32. Wilson JT, Brown RD, Cherek DR et al (1980) Drug excretion in human breast milk: principles, pharmacokinetics and projected consequences. Clin Pharmacokinet. 5(1):1–66

    Article  PubMed  CAS  Google Scholar 

  33. Shaxted EJ, Milton PJ (1979) Disopyramide in pregnancy: a case report. Curr Med Res Opin 6(1):70–72

    Article  PubMed  CAS  Google Scholar 

  34. Leonard RF, Braun TE, Levy AM (1978) Initiation of uterine contractions by disopyramide during pregnancy. N Engl J Med 299(2):84–85

    Article  PubMed  CAS  Google Scholar 

  35. Tadmor OP, Keren A, Rosenak D et al (1990) The effect of disopyramide on uterine contractions during pregnancy. Am J Obstet Gynecol 162(2):482–486

    PubMed  CAS  Google Scholar 

  36. Abbi M, Kriplani A, Singh B (1999) Preterm labor and accidental hemorrhage after disopyramide therapy in pregnancy. A case report. J Reprod Med 44(7):653–655

    CAS  Google Scholar 

  37. Brown WU, Bell GC, Lurie AO, Weiss B, Scanlon JW, Alper MH (1975) Newborn blood levels of lidocaine and mepivacaine in the first postnatal day following maternal epidural anesthesia. Anesthesiology 42(6):698–707

    Article  PubMed  CAS  Google Scholar 

  38. De Praeter C, Vanhaesebrouck P, De Praeter N, Govaert P, Bogaert M, Leroy J (1991) Episiotomy and neonatal lidocaine intoxication. Eur J Pediatr 150(9):685–686

    Article  PubMed  Google Scholar 

  39. Kim WY, Pomerance JJ, Miller AA (1979) Lidocaine intoxication in a newborn following local anesthesia for episiotomy. Pediatrics 64(5):643–645

    PubMed  CAS  Google Scholar 

  40. Shnider SM, Way EL (1968) Plasma levels of lidocaine (Xylocaine) in mother and newborn following obstetrical conduction anesthesia: clinical applications. Anesthesiology 29(5):951–958

    Article  PubMed  CAS  Google Scholar 

  41. Brown WU Jr, Bell GC, Alper MH (1976) Acidosis, local anesthetics, and the newborn. Obstet Gynecol 48(1):27–30

    PubMed  Google Scholar 

  42. Gregg AR, Tomich PG (1988) Mexilitene use in pregnancy. J Perinatol 8(1):33–35

    PubMed  CAS  Google Scholar 

  43. Lownes HE, Ives TJ (1987) Mexiletine use in pregnancy and lactation. Am J Obstet Gynecol 157(2):446–447

    PubMed  CAS  Google Scholar 

  44. Timmis AD, Jackson G, Holt DW (1980) Mexiletine for control of ventricular dysrhythmias in pregnancy. Lancet 2(8195 Pt 1):647–648

    Article  PubMed  CAS  Google Scholar 

  45. Villanova C, Muriago M, Nava F (1998) Arrhythmogenic right ventricular dysplasia: pregnancy under flecainide treatment. G Ital Cardiol 28(6):691–693

    PubMed  CAS  Google Scholar 

  46. Ahmed K, Issawi I, Peddireddy R (1996) Use of flecainide for refractory atrial tachycardia of pregnancy. Am J Crit Care 5(4):306–308

    PubMed  CAS  Google Scholar 

  47. Connaughton M, Jenkins BS (1994) Successful use of flecainide to treat new onset maternal ventricular tachycardia in pregnancy. Br Heart J 72(3):297

    Article  PubMed  CAS  Google Scholar 

  48. Doig JC, McComb JM, Reid DS (1992) Incessant atrial tachycardia accelerated by pregnancy. Br Heart J 67(3): 266–268

    Article  PubMed  CAS  Google Scholar 

  49. Gerli S, Clerici G, Mattei A, Di Renzo GC (2006) Flecainide treatment of fetal tachycardia and hydrops fetalis in a twin pregnancy. Ultrasound Obstet Gynecol 28(1):117

    Article  PubMed  CAS  Google Scholar 

  50. Allan LD, Chita SK, Sharland GK, Maxwell D, Priestley K (1991) Flecainide in the treatment of fetal tachycardias. Br Heart J 65(1):46–48

    Article  PubMed  CAS  Google Scholar 

  51. Wagner X, Jouglard J, Moulin M, Miller AM, Petitjean J, Pisapia A (1990) Coadministration of flecainide acetate and sotalol during pregnancy: lack of teratogenic effects, passage across the placenta, and excretion in human breast milk. Am Heart J 119(3 Pt 1):700–702

    Article  PubMed  CAS  Google Scholar 

  52. Braverman AC, Bromley BS, Rutherford JD (1991) New onset ventricular tachycardia during pregnancy. Int J Cardiol 33(3):409–412

    Article  PubMed  CAS  Google Scholar 

  53. Libardoni M, Piovan D, Busato E, Padrini R (1991) Transfer of propafenone and 5-OH-propafenone to foetal plasma and maternal milk. Br J Clin Pharmacol 32(4):527–528

    Article  PubMed  CAS  Google Scholar 

  54. Frishman WH, Chesner M (1988) Beta-adrenergic blockers in pregnancy. Am Heart J 115(1 Pt 1):147–152

    Article  PubMed  CAS  Google Scholar 

  55. Lydakis C, Lip GY, Beevers M, Beevers DG (1999) Atenolol and fetal growth in pregnancies complicated by hypertension. Am J Hypertens 12(6):541–547

    Article  PubMed  CAS  Google Scholar 

  56. Lip GY, Beevers M, Churchill D, Shaffer LM, Beevers DG (1997) Effect of atenolol on birth weight. Am J Cardiol 79(10):1436–1438

    Article  PubMed  CAS  Google Scholar 

  57. Beardmore KS, Morris JM, Gallery ED (2002) Excretion of antihypertensive medication into human breast milk: a systematic review. Hypertens Pregnancy 21(1):85–95

    Article  PubMed  CAS  Google Scholar 

  58. Lindeberg S, Sandstrom B, Lundborg P, Regardh CG (1984) Disposition of the adrenergic blocker metoprolol in the late-pregnant woman, the amniotic fluid, the cord blood and the neonate. Acta Obstet Gynecol Scand Suppl 118:61–64

    Article  PubMed  CAS  Google Scholar 

  59. O’Hare MF, Leahey W, Murnaghan GA, McDevitt DG (1983) Pharmacokinetics of sotalol during pregnancy. Eur J Clin Pharmacol 24(4):521–524

    Article  PubMed  Google Scholar 

  60. O’Hare MF, Murnaghan GA, Russell CJ, Leahey WJ, Varma MP, McDevitt DG (1980) Sotalol as a hypotensive agent in pregnancy. Br J Obstet Gynaecol 87(9):814–820

    Article  PubMed  Google Scholar 

  61. O’Hare MF, Russell CJ, Leahey WJ, Varma MP, Murnaghan GA, McDevitt DG (1979) Sotalol in the management of hypertension complicating pregnancy [proceedings]. Br J Clin Pharmacol 8(4):390P–391P

    Article  PubMed  Google Scholar 

  62. Danielsson BR, Skold AC, Azarbayjani F (2001) Class III antiarrhythmics and phenytoin: teratogenicity due to embryonic cardiac dysrhythmia and reoxygenation damage. Curr Pharm Des 7(9):787–802

    Article  PubMed  CAS  Google Scholar 

  63. Webster WS, Brown-Woodman PD, Snow MD, Danielsson BR (1996) Teratogenic potential of almokalant, dofetilide, and d-sotalol: drugs with potassium channel blocking activity. Teratology 53(3):168–175

    Article  PubMed  CAS  Google Scholar 

  64. Burkart TA, Kron J, Miles WM, Conti JB, Gonzalez MD (2007) Successful termination of atrial flutter by ibutilide during pregnancy. Pacing Clin Electrophysiol 30(2):283–286

    Article  PubMed  Google Scholar 

  65. Kockova R, Kocka V, Kiernan T, Fahy GJ (2007) Ibutilide-induced cardioversion of atrial fibrillation during pregnancy. J Cardiovasc Electrophysiol 18(5):545–547

    Article  PubMed  Google Scholar 

  66. Marks TA, Terry RD (1996) Developmental toxicity of ibutilide fumarate in rats after oral administration. Teratology 54(3):157–164

    Article  PubMed  CAS  Google Scholar 

  67. McKenna WJ, Harris L, Rowland E, Whitelaw A, Storey G, Holt D (1983) Amiodarone therapy during pregnancy. Am J Cardiol 51(7):1231–1233

    Article  PubMed  CAS  Google Scholar 

  68. Robson DJ, Jeeva Raj MV, Storey GC, Holt DW (1985) Use of amiodarone during pregnancy. Postgrad Med J 61: 75–77

    Article  PubMed  CAS  Google Scholar 

  69. Foster CJ, Love HG (1988) Amiodarone in pregnancy. Case report and review of the literature. Int J Cardiol 20(3): 307–316

    Article  PubMed  CAS  Google Scholar 

  70. Strunge P, Frandsen J, Andreasen F (1988) Amiodarone during pregnancy. Eur Heart J 9(1):106–109

    PubMed  CAS  Google Scholar 

  71. Plomp TA, Vulsma T, de Vijlder JJ (1992) Use of amiodarone during pregnancy. Eur J Obstet Gynecol Reprod Biol 43(3):201–207

    Article  PubMed  CAS  Google Scholar 

  72. Valensise H, Civitella C, Garzetti GG, Romanini C (1992) Amiodarone treatment in pregnancy for dilatative cardiomyopathy with ventricular malignant extrasystole and normal maternal and neonatal outcome. Prenat Diagn 12(9): 705–708

    Article  PubMed  CAS  Google Scholar 

  73. Magee LA, Downar E, Sermer M, Boulton BC, Allen LC, Koren G (1995) Pregnancy outcome after gestational exposure to amiodarone in Canada. Am J Obstet Gynecol 172(4 Pt 1):1307–1311

    Article  PubMed  CAS  Google Scholar 

  74. Bartalena L, Bogazzi F, Braverman LE, Martino E (2001) Effects of amiodarone administration during pregnancy on neonatal thyroid function and subsequent neurodevelopment. J Endocrinol Invest 24(2):116–130

    PubMed  CAS  Google Scholar 

  75. Widerhorn J, Bhandari AK, Bughi S, Rahimtoola SH, Elkayam U (1991) Fetal and neonatal adverse effects profile of amiodarone treatment during pregnancy. Am Heart J 122(4 Pt 1):1162–1166

    Article  PubMed  CAS  Google Scholar 

  76. Pitcher D, Leather HM, Storey GC, Holt DW (1983) Amiodarone in pregnancy. Lancet 1(8324):597–598

    Article  PubMed  CAS  Google Scholar 

  77. Tan HL, Lie KI (2001) Treatment of tachyarrhythmias during pregnancy and lactation. Eur Heart J 22(6):458–464

    Article  PubMed  CAS  Google Scholar 

  78. Byerly WG, Hartmann A, Foster DE, Tannenbaum AK (1991) Verapamil in the treatment of maternal paroxysmal supraventricular tachycardia. Ann Emerg Med 20(5):552–554

    Article  PubMed  CAS  Google Scholar 

  79. Cleary-Goldman J, Salva CR, Infeld JI, Robinson JN (2003) Verapamil-sensitive idiopathic left ventricular tachycardia in pregnancy. J Matern Fetal Neonatal Med 14(2):132–135

    Article  PubMed  CAS  Google Scholar 

  80. Rey E, Duperron L, Gauthier R, Lemay M, Grignon A, LeLorier J (1985) Transplacental treatment of tachycardia-induced fetal heart failure with verapamil and amiodarone: a case report. Am J Obstet Gynecol 153(3):311–312

    PubMed  CAS  Google Scholar 

  81. Rimar JM (1985) Verapamil for fetal supraventricular tachycardia. MCN Am J Matern Child Nurs 10(5):345

    Article  PubMed  CAS  Google Scholar 

  82. Klein V, Repke JT (1984) Supraventricular tachycardia in pregnancy: cardioversion with verapamil. Obstet Gynecol 63(3 Suppl):16S–18S

    PubMed  CAS  Google Scholar 

  83. Owen J, Colvin EV, Davis RO (1988) Fetal death after successful conversion of fetal supraventricular tachycardia with digoxin and verapamil. Am J Obstet Gynecol 158(5):1169–1170

    PubMed  CAS  Google Scholar 

  84. Truccone N, Mariona F (1985) Intrauterine conversion of fetal supraventricular tachycardia with combination of digoxin and verapamil. Pediatr Pharmacol (New York) 5(2):149–153

    CAS  Google Scholar 

  85. Lilja H, Karlsson K, Lindecrantz K, Sabel KG (1984) Treatment of intrauterine supraventricular tachycardia with digoxin and verapamil. J Perinat Med 12(3):151–154

    Article  PubMed  CAS  Google Scholar 

  86. Lubbe WF (1987) Use of diltiazem during pregnancy. N Z Med J 100(818):121

    PubMed  CAS  Google Scholar 

  87. Khandelwal M, Kumanova M, Gaughan JP, Reece EA (2002) Role of diltiazem in pregnant women with chronic renal disease. J Matern Fetal Neonatal Med 12(6):408–412

    Article  PubMed  CAS  Google Scholar 

  88. Cullhed I (1983) Cardioversion during pregnancy. A case report. Acta Med Scand 214(2):169–172

    Article  CAS  Google Scholar 

  89. Finlay AY, Edmunds V (1979) D.C. cardioversion in pregnancy. Br J Clin Pract 33(3):88–94

    PubMed  CAS  Google Scholar 

  90. Klepper I (1981) Cardioversion in late pregnancy. The anaesthetic management of a case of Wolff-Parkinson-White syndrome. Anaesthesia 36(6):611–616

    Article  PubMed  CAS  Google Scholar 

  91. Ogburn PL Jr, Schmidt G, Linman J, Cefalo RC (1982) Paroxysmal tachycardia and cardioversion during pregnancy. J Reprod Med 27(6):359–362

    PubMed  Google Scholar 

  92. Schroeder JS, Harrison DC (1971) Repeated cardioversion during pregnancy. Treatment of refractory paroxysmal atrial tachycardia during 3 successive pregnancies. Am J Cardiol 27(4):445–446

    Article  PubMed  CAS  Google Scholar 

  93. Rosemond RL (1993) Cardioversion during pregnancy. JAMA 269(24):3167

    Article  PubMed  CAS  Google Scholar 

  94. Barnes EJ, Eben F, Patterson D (2002) Direct current cardioversion during pregnancy should be performed with facilities available for fetal monitoring and emergency caesarean section. BJOG 109(12):1406–1407

    Article  PubMed  Google Scholar 

  95. Atta E, Gardner M (2007) Cardiopulmonary resuscitation in pregnancy. Obstet Gynecol Clin North Am 34(3):585–597

    Article  PubMed  Google Scholar 

  96. Morris S, Stacey M (2003) Resuscitation in pregnancy. BMJ 327(7426):1277–1279

    Article  PubMed  Google Scholar 

  97. Mallampalli A, Guy E (2005) Cardiac arrest in pregnancy and somatic support after brain death. Crit Care Med 33(10 Suppl):S325–331

    Google Scholar 

  98. Part 10.8: Cardiac Arrest Associated With Pregnancy. Circulation. December 13, 2005; 112 (24_suppl):IV-150–IV-153

    Google Scholar 

  99. Goodwin AP, Pearce AJ (1992)The human wedge. A manoeuvre to relieve aortocaval compression during resuscitation in late pregnancy. Anaesthesia 47(5):433–434

    Article  PubMed  CAS  Google Scholar 

  100. Nanson J, Elcock D, Williams M, Deakin CD (2001) Do physiological changes in pregnancy change defibrillation energy requirements? Br J Anaesth 87(2):237–239

    Article  PubMed  CAS  Google Scholar 

  101. Suri V, Keepanasseril A, Aggarwal N, Vijayvergiya R, Chopra S, Rohilla M (2009) Maternal complete heart block in pregnancy: analysis of four cases and review of management. J Obstet Gynaecol Res 35(3):434–437

    Article  PubMed  Google Scholar 

  102. Minassian VA, Jazayeri A (2002) Favorable outcome in a pregnancy with complete fetal heart block and severe bradycardia. Obstet Gynecol 100(5 Pt 2):1087–1089

    Article  PubMed  Google Scholar 

  103. Dalvi BV, Chaudhuri A, Kulkarni HL, Kale PA (1992) Therapeutic guidelines for congenital complete heart block presenting in pregnancy. Obstet Gynecol 79(5 Pt 2):802–804

    PubMed  CAS  Google Scholar 

  104. Bemiller CR, Forker AD, Morgan JR (1970) Complete heart block, prosthetic aortic valve, and successful pregnancy. JAMA 214(5):915

    Article  PubMed  CAS  Google Scholar 

  105. Ginns HM, Hollinrake K (1970) Complete heart block in pregnancy treated with an internal cardiac pacemaker. J Obstet Gynaecol Br Commonw 77(8):710–712

    Article  PubMed  CAS  Google Scholar 

  106. Schonbrun M, Rowland W, Quiroz AC (1966) Complete heart block in pregnancy. Successful use of an intravenous pacemaker in 2 patients during labor. Obstet Gynecol 27(2):243–246

    PubMed  CAS  Google Scholar 

  107. Middleton EB, Lee YC (1971) Pregnancy associated with cardiac pacemaker generator implanted in abdominal wall. A case report. Obstet Gynecol 38(2):272–275

    CAS  Google Scholar 

  108. Bilge M, Guler N, Eryonucu B (1999) Recurrent pulmonary emboli and thrombus attached to a permanently implanted pacemaker wire in pregnancy. Acta Cardiol 54(2):97–99

    PubMed  CAS  Google Scholar 

  109. Sharma JB, Malhotra M, Pundir P (2000) Successful pregnancy outcome with cardiac pacemaker after complete heart block. Int J Gynaecol Obstet 68(2):145–146

    Article  PubMed  CAS  Google Scholar 

  110. Pedrinazzi C, Gazzaniga P, Durin O, Tovena D, Inama G (2008) Implantation of a permanent pacemaker in a pregnant woman under the guidance of electrophysiologic signals and transthoracic echocardiography. J Cardiovasc Med (Hagerstown) 9(11):1169–1172

    Article  Google Scholar 

  111. Antonelli D, Bloch L, Rosenfeld T (1999) Implantation of permanent dual chamber pacemaker in a pregnant woman by transesophageal echocardiographic guidance. Pacing Clin Electrophysiol 22(3):534–535

    Article  PubMed  CAS  Google Scholar 

  112. Gudal M, Kervancioglu C, Oral D, Gurel T, Erol C, Sonel A (1987) Permanent pacemaker implantation in a pregnant woman with the guidance of ECG and two-dimensional echocardiography. Pacing Clin Electrophysiol 10(3 Pt 1): 543–545

    Article  PubMed  CAS  Google Scholar 

  113. Piper JM, Berkus M, Ridgway LE 3rd (1992) Pregnancy complicated by chronic cardiomyopathy and an automatic implantable cardioverter defibrillator. Am J Obstet Gynecol 167(2):506–507

    PubMed  CAS  Google Scholar 

  114. Isaacs JD, Mulholland DH, Hess LW, Allbert JR, Martin RW (1993) Pregnancy in a woman with an automatic implantable cardioverter-defibrillator. A case report. J Reprod Med 38(6):487–488

    CAS  Google Scholar 

  115. Bonini W, Botto GL, Broffoni T, Dondina C (2000) Pregnancy with an ICD and a documented ICD discharge. Europace 2(1):87–90

    Article  PubMed  CAS  Google Scholar 

  116. Olufolabi AJ, Charlton GA, Allen SA, Mettam IM, Roberts PR (2002) Use of implantable cardioverter defibrillator and anti-arrhythmic agents in a parturient. Br J Anaesth 89(4):652–655

    Article  PubMed  CAS  Google Scholar 

  117. Abello M, Peinado R, Merino JL et al (2003) Cardioverter defibrillator implantation in a pregnant woman guided with transesophageal echocardiography. Pacing Clin Electrophysiol 26(9):1913–1914

    Article  PubMed  Google Scholar 

  118. Doyle NM, Monga M, Montgomery B, Dougherty AH (2005) Arrhythmogenic right ventricular cardiomyopathy with implantable cardioverter defibrillator placement in pregnancy. J Matern Fetal Neonatal Med 18(2):141–144

    Article  PubMed  Google Scholar 

  119. Natale A, Davidson T, Geiger MJ, Newby K (1997) Implantable cardioverter-defibrillators and pregnancy: a safe combination? Circulation 96(9):2808–2812

    Article  PubMed  CAS  Google Scholar 

  120. Bongiorni MG, Di Cori A, Soldati E et al (2008) Radiofrequency catheter ablation of atrioventricular nodal reciprocating tachycardia using intracardiac echocardiography in pregnancy. Europace 10(8):1018–1021

    Article  PubMed  Google Scholar 

  121. Kanjwal Y, Kosinski D, Kanj M, Thomas W, Grubb B (2005) Successful radiofrequency catheter ablation of left lateral accessory pathway using transseptal approach during pregnancy. J Interv Card Electrophysiol 13(3):239–242

    Article  PubMed  Google Scholar 

  122. Pagad SV, Barmade AB, Toal SC, Vora AM, Lokhandwala YY (2004) ‘Rescue’ radiofrequency ablation for atrial tachycardia presenting as cardiomyopathy in pregnancy. Indian Heart J 56(3):245–247

    PubMed  Google Scholar 

  123. Bombelli F, Lagona F, Salvati A, Catalfamo L, Ferrari AG, Pappone C (2003) Radiofrequency catheter ablation in drug refractory maternal supraventricular tachycardias in advanced pregnancy. Obstet Gynecol 102(5 Pt 2):1171–1173

    Article  PubMed  CAS  Google Scholar 

  124. Dominguez A, Iturralde P, Hermosillo AG, Colin L, Kershenovich S, Garrido LM (1999) Successful radiofrequency ablation of an accessory pathway during pregnancy. Pacing Clin Electrophysiol 22(1 Pt 1):131–134

    Article  PubMed  CAS  Google Scholar 

  125. Gleicher N, Meller J, Sandler RZ, Sullum S (1981) Wolff-Parkinson-White syndrome in pregnancy. Obstet Gynecol 58(6):748–752

    PubMed  CAS  Google Scholar 

  126. Kounis NG, Zavras GM, Papadaki PJ, Soufras GD, Kitrou MP, Poulos EA (1995) Pregnancy-induced increase of supraventricular arrhythmias in Wolff-Parkinson-White syndrome. Clin Cardiol 18(3):137–140

    Article  PubMed  CAS  Google Scholar 

  127. Schwartz PJ, Priori SG, Spazzolini C et al (2001) Genotype-phenotype correlation in the long-QT syndrome: gene-specific triggers for life-threatening arrhythmias. Circulation 103(1):89–95

    Article  PubMed  CAS  Google Scholar 

  128. Rashba EJ, Zareba W, Moss AJ et al (1998) Influence of pregnancy on the risk for cardiac events in patients with hereditary long QT syndrome. LQTS investigators. Circulation 97(5):451–456

    Article  PubMed  CAS  Google Scholar 

  129. Seth R, Moss AJ, McNitt S et al (2007) Long QT syndrome and pregnancy. J Am Coll Cardiol 49(10):1092–1098

    Article  PubMed  Google Scholar 

  130. Thaman R, Varnava A, Hamid MS et al (2003) Pregnancy related complications in women with hypertrophic cardiomyopathy. Heart 89(7):752–756

    Article  PubMed  CAS  Google Scholar 

  131. Pelliccia F, Cianfrocca C, Gaudio C, Reale A (1992) Sudden death during pregnancy in hypertrophic cardiomyopathy. Eur Heart J 13(3):421–423

    PubMed  CAS  Google Scholar 

  132. Autore C, Conte MR, Piccininno M et al (2002) Risk associated with pregnancy in hypertrophic cardiomyopathy. J Am Coll Cardiol 40(10):1864–1869

    Article  PubMed  Google Scholar 

  133. Proceedings of the 32ND Bethesda Conference (2001) Care of the adult with congenital heart disease. J Am College Cardiol 37:1161–1198

    Google Scholar 

  134. Siu SC, Sermer M, Harrison DA et al (1997) Risk and predictors for pregnancy-related complications in women with heart disease. Circulation 96(9):2789–2794

    Article  PubMed  CAS  Google Scholar 

  135. Siu SC, Sermer M, Colman JM et al (2001) Prospective multicenter study of pregnancy outcomes in women with heart disease. Circulation 104(5):515–521

    Article  PubMed  CAS  Google Scholar 

  136. Silversides CK, Harris L, Haberer K, Sermer M, Colman JM, Siu SC (2006) Recurrence rates of arrhythmias during pregnancy in women with previous tachyarrhythmia and impact on fetal and neonatal outcomes. Am J Cardiol 97(8):1206–1212

    Article  PubMed  Google Scholar 

  137. Tateno S, Niwa K, Nakazawa M, Akagi T, Shinohara T, Yasuda T (2003) Arrhythmia and conduction disturbances in patients with congenital heart disease during pregnancy: multicenter study. Circ J 67(12):992–997

    Article  PubMed  Google Scholar 

  138. Niwa K, Tateno S, Akagi T et al (2007) Arrhythmia and reduced heart rate variability during pregnancy in women with congenital heart disease and previous reparative surgery. Int J Cardiol 122(2):143–148

    Article  PubMed  Google Scholar 

  139. Drenthen W, Pieper PG, Ploeg M et al (2005) Risk of complications during pregnancy after Senning or Mustard (atrial) repair of complete transposition of the great arteries. Eur Heart J 26(23):2588–2595

    Article  PubMed  Google Scholar 

  140. Megerian G, Bell JG, Huhta JC, Bottalico JN, Weiner S (1994) Pregnancy outcome following Mustard procedure for transposition of the great arteries: a report of five cases and review of the literature. Obstet Gynecol 83(4):512–516

    Article  PubMed  CAS  Google Scholar 

  141. Meijer JM, Pieper PG, Drenthen W et al (2005) Pregnancy, fertility, and recurrence risk in corrected tetralogy of Fallot. Heart 91(6):801–805

    Article  PubMed  CAS  Google Scholar 

  142. Gibson PS, Powrie R, Pipert J (2001) Prevalence of syncope and recurrent presyncope during pregnancy. Obstet Gynecol Surv 97:S41–S42

    Google Scholar 

  143. Goland S, Elkayam U (2009) Cardiovascular problems in pregnant women with marfan syndrome. Circulation 119(4):619–623

    Article  PubMed  Google Scholar 

  144. Meijboom LJ, Vos FE, Timmermans J, Boers GH, Zwinderman AH, Mulder BJ (2005) Pregnancy and aortic root growth in the Marfan syndrome: a prospective study. Eur Heart J 26(9):914–920

    Article  PubMed  Google Scholar 

  145. Yetman AT, Bornemeier RA, McCrindle BW (2003) Long-term outcome in patients with Marfan syndrome: is aortic dissection the only cause of sudden death? J Am Coll Cardiol 41(2):329–332

    Article  PubMed  Google Scholar 

  146. Berlinerblau R, Yessian A, Lichstein E, Haberman S, Oruci E, Jewelewicz R (2001) Maternal arrhythmias of normal labor and delivery. Gynecol Obstet Invest 52(2):128–131

    Article  PubMed  CAS  Google Scholar 

  147. Romem A, Romem Y, Katz M, Battler A (2004) Incidence and characteristics of maternal cardiac arrhythmias during labor. Am J Cardiol 93(7):931–933

    Article  PubMed  Google Scholar 

  148. Anderson GD (2006) Using pharmacokinetics to predict the effects of pregnancy and maternal-infant transfer of drugs during lactation. Expert Opin Drug Metab Toxicol 2(6):947–960

    Article  PubMed  CAS  Google Scholar 

  149. American Academy of Pediatrics Committee on Drugs (2001) The Transfer of Drugs and Other Chemicals into Human Milk. Pediatrics 108(3):776–789

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA

    Kristen K. Patton MD

  2. Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA

    Richard L. Page MD

Authors
  1. Kristen K. Patton MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Richard L. Page MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Main Line Health Heart Center, 100 Lancaster Ave, Wynnewood, 19096, Pennsylvania, USA

    Gan-Xin Yan

  2. Main Line Health Heart Center, 100 Lancaster Ave, Wynnewood, 19096, Pennsylvania, USA

    Peter R. Kowey

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Patton, K.K., Page, R.L. (2011). Arrhythmias in Pregnancy and Postpartum. In: Yan, GX., Kowey, P. (eds) Management of Cardiac Arrhythmias. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-161-5_16

Download citation

  • DOI: https://doi.org/10.1007/978-1-60761-161-5_16

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60761-160-8

  • Online ISBN: 978-1-60761-161-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation